Observational studyBMC health services research2021
Referral patterns to outpatient child and adolescent mental health services and factors associated with referrals being rejected. A cross-sectional observational study.
Observational study in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07399106 (EN-CAMHS 2), which is not on this map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
EN-CAMHS 2: Enhancing CAMHS Referrals
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Early-stage profiles of adolescent mental health difficulties and well-being: A systematic review of cluster analyses in large school and community samples.Journal of research on adolescence : the official journal of the Society for Research on Adolescence · 2025Pooled it
- Prenatal stress and externalizing behaviors in childhood and adolescence: A systematic review and meta-analysis.Psychological bulletin · 2024Pooled it
- Transitions from child to adult mental health care: the evidence-base for ESCAP guidance for clinicians.European child & adolescent psychiatry · 2026Article
- Article
- From profiles to precision: incorporating the Psychosocial Assessment Tool (PAT) and the Strengths and Difficulties Questionnaire (SDQ) to inform treatment planning in outpatient psychiatry.European child & adolescent psychiatry · 2026Article
- Mind the Gap! Sleep Problems in Children With ADHD-A Qualitative Analysis of Clinician Training Needs.Child: care, health and development · 2026Article
- Hospital triage of general practice referrals: exploring the role of triage in rejected referrals.BMC health services research · 2026Article
- Investigating the Applicability of the SAFER-YCL Care Bundle for Transitions From CAMHS Crisis and Liaison Services: The Barriers and Enablers.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Mental health problems in children and young people in Dutch general practice: trends in incidence and consultation rates from 2016 to 2022.Social psychiatry and psychiatric epidemiology · 2026Article
- The referral trajectories for young people with depression in low-resource settings: A qualitative study from Ghana and Zimbabwe.PloS one · 2026Article
- Danish primary care: a focus on general practice in the Danish healthcare system.Scandinavian journal of primary health care · 2025Article
- Promoting Healthy Screen Media Use in Young Children With Externalizing Behavior Problems Through an Adapted Parenting Intervention: Results of an Open Trial.Cognitive and behavioral practice · 2025Article
- Leveraging a Parenting Intervention to Support Healthy Media Use in U.S. Preschoolers with Externalizing Behavior: A Pilot Randomized Trial.Journal of children and media · 2025Article
- Referral Patterns, Pathways to Care, Symptom Profile, and Diagnoses of Children Attending a Child Psychiatry Unit in South India: A Retrospective Chart Review.Indian journal of psychological medicine · 2025Article
- Latest clinical frontiers related to autism diagnostic strategies.Cell reports. Medicine · 2025Review
- Investigating cross-sectional and longitudinal relationships between brain structure and distinct dimensions of externalizing psychopathology in the ABCD sample.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2025Article
- Characteristics of pediatric e-referrals through SMARC system: a two-year national analysis.Frontiers in medicine · 2025Article
- Environmental Exposure to Pesticides and the Risk of Child Neurodevelopmental Disorders.Medicina (Kaunas, Lithuania) · 2024Article
- SoCap YMH - youth mental health, social capital and help-seeking: a study protocol.Frontiers in public health · 2024Article
- Identifying Risk Factors Associated with Repeated Referrals Within a Pediatric Navigation Program.Journal of community health · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOutpatient child and adolescent mental health services (CAMHS) are faced with the challenge of balancing increasing demands with limited resources. An additional challenge is high rejection rates of referrals which causes frustration for referring agents and families. In order to effectively plan and allocate available resources within CAMHS there is a need for up-to-date knowledge on referral patterns and factors associated with rejection of referrals.
methodsIn this cross-sectional observational study we did a retrospective review of all referrals (n = 1825) for children (0-18) referred for assessment at the outpatient CAMHS of the North Denmark Region in 2018.
resultsThe most common referral reasons to CAMHS were attention deficit disorder (ADHD/ADD) (27.9%), autism spectrum disorder (22.4%), affective disorders (14.0%) and anxiety disorders (11.6%). The majority of referrals came from general practitioners, but for neurodevelopmental disorders educational psychologists were the primary referral source. Re-referrals constituted more than a third of all referrals (35.9%). Children in care were overrepresented in this clinical sample and had an increased risk (Adj. OR 2.54) of having their referrals rejected by CAMHS. Referrals from general practitioners were also associated with an increased risk of rejection (Adj. OR 3.29).
conclusionsA high proportion of children with mental disorders have a repeated need for assessment by CAMHS. There is a need for future research on predictors of re-referral to outpatient services to identify potential targets for reducing re-referral rates as well as research on how to optimize service provision for children with a repeated need for assessment. General practitioners are the main gatekeepers to CAMHS and research on interventions to improve the referral process should be aimed towards general practitioners.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.